第二极体排出时间在预测体外受精结局中的价值

The value of the second polar body extruding time in predicting outcomes of in vitro fertilization

目的探讨第二极体(PB2)排出时间在预测体外受精结局中的价值。方法选择2010年10~12月在上海瑞金医院生殖医学中心行常规体外受精周期的患者,分别于授精后的3 h、4 h、5 h观察PB2出现情况。根据授精后5 h内是否排出PB2将卵子分为A组(有PB2排出)和B组(无PB2排出);再根据PB2排出时间,将A组的卵子分为A1(3 h排出)、A2(4 h排出)和A3组(5 h排出)。比较各组的受精率、卵裂率和可用胚胎率。结果授精后3 h约29.13%的卵子排出PB2,4 h约59.19%卵子排出PB2,5 h约68.25%卵子排出PB2;A组的受精率、两原核(two pronuclear,2PN)率、卵裂率和胚胎可用率显著高于B组(P<0.05),异常受精率两组比较无统计学差异(P>0.05);A1组的受精率、2PN率、卵裂率、可用胚胎率显著高于A2和A3组,异常受精率显著低于A2和A3组(P<0.05);A2和A3组的受精率、卵裂率和胚胎可用率比较,均无统计学差异(P>0.05)。结论体外受精周期中,根据PB2排出时间预测体外受精结局有一定的价值,但尚存局限性;PB2排出时间与胚胎质量存在一定的关系。

Objective The aim of this study was to evaluate the value of the second polar body(PB2) extruding time in predicting outcomes of in vitro fertilization.Methods Oocytes were collected from women who underwent routine in vitro fertilization and embryo transfer during October 2010 and December 2010 in our reproduction center.The presence of PB2 extrusion was observed at the third,fourth and fifth hour after insemination respectively.The oocytes,according to whether PB2 extrusion or not at 5 hours after insemination,were divided into two groups: group A with the second polar body extrusion and group B without PB2 extrusion.On the basis of PB2 extruding time,group A was further divided into three sub-groups: group A1,groupA2 and group A3,respectively.The fertilization rate,cleavage rate,and embryo quality were compared among the groups.Results The extrusion of PB2 at the third,fourth an fifth hour after insemination was 29.13%,59.19% and 68.25%,respectively.The fertilization rate,2PN rate and embryo available rate in group A were significantly higher than those in group B(P<0.05),and there were not significant differences in cleavage rate and abnormal fertilization rate between two groups(P>0.05).The fertilization rate,2PN rate,embryo available rate were significantly higher(P<0.05) in group A1 than those in group A2 and group A3(P<0.05).However,the abnormal fertilization rate was significantly lower than those in group A2 and group A3(P<0.05).There were no statistically significant difference in fertilization rate,cleavage rate and embryo available rate between group A2 and group A3(P>0.05).Conclusions PB2 extruding time has some value in predicting the outcomes of in vitro fertilization,but still has some limitations.There was a correlation between PB2 extruding time and embryo quality.